The Effect of Nursing Moral Distress on Intent to Leave Employment
Katherine Sheppard1, Catherine Smith, Merri K Morgan
1Author Affiliations: Manager (Dr Sheppard), Sentara Williamsburg Regional Medical Center; System Director (Dr Smith), Sentara Health, Norfolk; Manager (Dr Morgan), Sentara Obici Hospital, Suffolk; Chief Nursing Officer (Wilmoth) and Biostatistician (Dr Toepp), Sentara Health, Norfolk; and Professor Emeritus (Dr Rutledge) and Nurse Scientist (Dr Zimbro), Old Dominion University, Virginia Beach, VA.
Objective:
This study explored the impact of moral distress (MD) and respondent characteristics on intent to leave employment.
Background:
Managing patient care, within organizational constraints, may create physical discomfort or mental peace disturbances such as MD, negatively impacting RN retention.
Methods:
Responses from 948 RNs were collected using an anonymous online survey. The impact of MD on intent to leave employment was explored.
Results:
MD was significantly higher among RNs intending to leave employment. System-level and team-level integrity attributes were significant factors predicting intent to leave, controlling for potential confounders. The odds of intending to leave were 147% higher for new graduate RNs, 124% higher for direct care RNs, and 63% higher for 2nd-career RNs. Gender and race were not significant predictors.
Conclusion:
Exploring root causes contributing to MD frequency and severity is critical to maintain a healthy work environment. Mitigating MD in the work environment may enhance nursing practice and improve patient care. Support for new graduate and 2nd-career RNs can be realized, further reducing turnover for these vulnerable populations of the nursing workforce.
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